The present invention relates to orthopedic appliances and, more particularly, to an acromioclavicular strap-type stabilizer and supporting brace.
In orthopedics, the therapeutic value of immobilization, complete or partial, and pressure or tension has long been recognized. Orthopedic appliances have been designed for virtually every area of the human body to immobilize, provide support and/or provide tension or pressure to fractures or at dislocation sites. In some instances, an appliances may allow or provide for a degree of movement of the injured portion of the body or an adjacent limb.
One example of an orthopedic appliance is the clavicle apparatus disclosed in U.S. Pat. No. 1,808,422 (MacDonald). The disclosed apparatus is designed for maintaining the reduction of a fractured clavicle on either side of the body. It includes a half vest, vest bow, arm band, axilla pad, an elbow sling and a forearm sling. At least portions of the MacDonald clavicle apparatus are formed of elastic material, but it is not designed to provide a downwardly directed reduction force on the acromioclavicular joint. Also, to free the arm supported or confined by the slings and the arm band would be time consuming.
U.S. Pat. No. 3,404,680 (Guttman) discloses a surgical sling adapted for use on injuries around the shoulder girdle. The sling applies pressure to the collar bone where desired, is adjustable, and can be removed and replaced by the patient wearing it. The sling is made of webbing or strapping and includes a shoulder pad or collar bone engaging pad preferably made of sponge rubber, enclosed in a soft leather covering. The sling also includes an arm supporting sling feature. The ends of the sling are provided with a hook and loop material for connecting them to each other. Like the MacDonald clavicle apparatus, the Guttman sling requires an upper arm embracing loop, a strap for holding the upper arm of the user in close proximity to the body.
U.S. Pat. No. 4,491,129 (Lockwood) discloses a strapping assembly method for the treatment of acromioclavicular separations wherein the assembly includes a stocking that is worn on the leg of a patient on the side opposite the injury. This stocking serves as an anchor. A tension member is connected to the stocking through an adjustable garter and extends upwardly across the patient's back to the shoulder on the side of the injury then over the shoulder and downward to the patient's forearm. The strap is looped around the forearm to hold it in sling fashion, and the weight of the forearm places the strap under tension. While the stocking may provide an anchor, unless the forearm is constantly and completely relaxed, the variable force produced by the forearm makes it difficult to maintain fairly constant compression on the acromioclavicular separation.
U.S. Pat. Nos. 5,487,724 and 5,538,499 (Schwenne et al.) disclose orthopedic shoulder braces that are designed to evenly distribute weight onto a patient's waist and hip. The braces include generally rigid anatomically conforming shells connected by straps. While the Schwenne et al. braces may permit some movement, they include a rigid upright portion and upper arm support portions and are designed primarily for immobilization and support.
U.S. Pat. No. 4,188,944 (Augustyniak) discloses an acromioclavicular-clavicular restoration brace having a resilient and shape-retentive shoulder block having an arcuate concavity adapted to rest upon the clavicular joint of a patient, and a lower, forearm block for receiving the patient's forearm. The shoulder block is mounted on straps forming a harness which retains the block on the joint and applies a downward force on the block. The shoulder and upper body straps are made of elastic, and the upper body loop is connected to the shoulder strap. In use, the shoulder strap is placed on the patient with the shoulder block in position on the acromioclavicular-joint and the forearm resting in the lower block. A buckle is provided to adjust the vertical tension in the shoulder strap, but the carrying of the arm at the bottom of the strap may cause too much variation in the tension. While the Augustyniak patent mentions that there are drawbacks with existing devices because they excessively immobilize the entire body, and the Augustyniak brace may be less confining than some, releasing the arm from the lower block to use the arm on the injured side would cause an immediate reduction in pressure on the acromioclavicular joint possibly causing pain or reinjuring the joint or the clavicle.
It would be advantageous if there were an orthopedic appliance which could apply substantially even, constant pressure to the acromioclavicular joint, while minimizing the confinement and discomfort of a person wearing the appliance and permitting the selective use of the wearer's arm on the injured or treated side of the body without substantially disrupting the pressure on the acromioclavicular joint.